Britain’s care homes feel abandoned amid national rise in cases

As the daily number of coronavirus cases ticks up across the country worries are growing about a potential second wave. Already, questions about whether the NHS will be able to cope are making headlines. However, social care, despite having been hit extremely hard during the first wave, seems to be once again finding itself ignored.

At the peak of pandemic over 400 care home residents were dying every day according to research by the PA news agency. While the mainly elderly and infirm residents of these institutions were innately more susceptible to coronavirus government decisions to prioritise the NHS, while dumping untested patients in care homes, greatly contributed to the death toll.

Now, as the country prepares for a potential second wave, care homes are worrying they could face a repeat. Robert Kilgour, Executive Chairman of Renaissance Care Homes, asked: “Are we back to NHS first and social care second?”

At the forefront of Kilgour’s mind is testing. On July 3, sometime after the initial peak had passed, the government announced that care home staff would be tested once a week, and residents once every four weeks.

Care homes welcome the move. Regular testing, particularly of staff who move in and out of the care home, is vital for infection control and once in a care home coronavirus can spread like wildfire.

However, actual implementation seems to have been mixed. While some care home owners say that their staffs were indeed tested once a week with results available within 24-48 hours other sources spoke of cases where workers had only been tested once without regular follow-ups.

Now, even care homes which previously had had access to regular testing and prompt results are complaining that the wait for results has become substantially longer within the past two weeks. In some cases staff have waited up to a week for their results. Care home owners have said they are being told that the return to universities and schools has created an influx of new tests which labs don’t have the capacity to process.

The government has apologised and is planning to expand testing capacity. Still, the care home owners Reaction spoke to were less than impressed. Kilgour said: “It’s very frustrating. It’s not like they didn’t know schools were re-opening. It’s not good enough, and its not fair on the staff whose morale has really taken a blow due to this.”

Meanwhile, in the view of Mike Padgham, Chair of the Independent Care Group: “They [the government] only got testing right for a few weeks. It was slow and patchy early on, worked for a few weeks, and now we’re seeing delays.”

PPE represents another potential challenge. For the time being care homes seems have sufficient supplies and in the absence much government support, care homes have also been co-operating by letting each other what suppliers were reliable.  Still, according to Padgham stockpiles might only go so far. “If there’s a second wave we might go into the winter with a PPE shortage again.”

Equally worryingly, another source claimed there have been anecdotal cases of care homes, with an eye on the bottom line, restricting staff access to PPE.

While this seems to be far from common it points to the wider issue of funding. A lack of funding has long been a problem for the sector, and the costs of the pandemic have imposed extra strain.

While the government has provided some extra financial support for care homes some are saying it was not enough. Padgham said: “The funding was only there for the short term. Where’s the funding for the winter?”

Nor is the funding available always put its proper use. The government has established a fund to help care homes pay their staff full wages when they need to self-isolate, vital for infection control in a sector where low-waged employees are reluctant to lose any earnings. Yet, despite this, some social care workers claim that their employers are still paying them only statutory sick pay.

Burnout is also unsurprisingly a problem. Low wages, long hours, and the stress of the crisis – especially seeing often beloved residents die – has got to many workers. And, while there has been a lull over summer, some expect things to even worse the next time around.

According to Padgham: “Staff have had a chance to catch their breath but it’s going be tougher this time [if there’s a second wave]”.

Indeed, should a second wave come care home staff will likely find little support from the NHS. Winter is always a busy time for the NHS and, as a government commissioned report by the Academy of Medical Sciences makes clear, this year it will likely be stretched to its absolute limits.

Already a British Medical Association survey found that 65.33% of doctors were either not at all or not very confident in their ability to manage patient demand in community settings such as care homes when normal NHS service resumed.  A second coronavirus wave would almost certainly worsen the situation.

Given that social care – which remains in private hands despite playing a vital role in helping the NHS stay running – is often treated as the NHS’ poor relation at the best of time this is cause for concern. During the first wave care homes struggled to get even reported cases of GPs refusing to enter care homes dealing with outbreaks. It seems all too likely that in a second wave care homes will once again bear the brunt.

If there is reason for hope it is that care homes, after their bruising first experience do seem to be doing their best to prepare. According to Kilgour: “We’re [Renaissance Care] much more cautious and careful, but also braver on making decisions. After our internal review I wish I had locked down a week earlier. This time we’ll not be bullied into closing too late, or opening too soon.”

Still, in a sector which was struggling with staffing and funding even before the pandemic hit it seems inevitable other care homes will be less prepared. And, without regular testing providing prompt results it seems that even the best prepared will likely struggle to prevent further tragedies.